Pediatrics

Pediatric age groups 

Newborn/ Neonate —> first 4 weeks of life

Infant —> 1 month - 1 year

Toddler —> 1 year - 2 years

Preschool —> 3 years - 5 years

School Age —> 6 years - 12 years 

Adolescent —> 13 years - 17 years

Stages of Play

0-3 months —> unoccupied play (moves alone)

0-2 years —> solitary play (playing alone)

2 years —> onlooker (watches other children)

2 years —> parallel play ( play next to other kids but not together)

3 years - 4 years —> associative play (playing the same game but not together)

4years + —> cooperative play (playing as a team/group)

Milestone Categories

Gross Motor Skills —> large movements

Fine Motor Skills —> intricate movements (often involving hands/ claw movement)

Language —> verbal and non verbal expressions 

Cognitive —> how children understand the would around them 

1 Month Milestones

Gross Motor Skills —> head lag (head lags behind body when pulling infant into sitting position)

Fine Motor Skills —> Palmer grasp reflex (involuntary grasps when palm is touched)

Language —> crying 

Cognitive —> tracks moving items with eyes

2-3 Month Milestones

Gross Motor Skills —> raises head and chest

Fine Motor Skills —> palmer grasp disappearing/ absent

Language —> makes cooing noises

Cognitive —> smiles 

4-5 Month Milestones

Gross Motor Skills —> rolls from tummy to back

Fine Motor Skills —> attempts to grab items

Language —> single syllable babbles

Cognitive —> remembers faces, may cry when caretakers leave

6-7 Month Milestones

Gross Motor Skills —> sits in tripod position

Fine Motor Skills —> transfers items between hands

Language —> imitates sounds

Cognitive —> develops stranger anxiety 

8-9 Month Milestones

Gross Motor Skills —> standing up/ walking while holding onto items (ex couch/ table) 

Fine Motor Skills —> developing pincer grasp (thumb & index finger)

Language —> more expressive (laughs, screeches, and squeals)

Cognitive —> object permanence ( things exist even when they aren’t seen)

10-12 Month Milestones

Gross Motor Skills —>  Takes independent steps/ begins walking 

Fine Motor Skills —> fully developed pincer grasp thumb & index finger)

Language —> two syllable “words” (Ma ma, Da da, Uh oh)  

Cognitive —> separation anxiety 

15 Month Milestones

Gross Motor Skills —> independent walking

Fine Motor Skills —> claps & points 

Language —>  understands names 

Cognitive —> tantrums when unhappy

18 Month Milestones

Gross Motor Skills —> throw a ball over their head

Fine Motor Skills —> scribbles with crayons/ markers

Language —>  answers yes/no questions

Cognitive —> learns independently

2 Year Milestones

Gross Motor Skills —> Can kick a ball, walks on stairs with help

Fine Motor Skills —> points at items in picture book

Language —>  forms 2-3 word sentences 

Cognitive —> parallel play (next to each other but not together) 

3 Year Milestones 

Gross Motor Skills —> jumps, can walk up & down stairs (1 foot per step)

Fine Motor Skills —> uses scissors 

Language —> WHY questions 

Cognitive —> associative play (plays same games but not together)

4 Year Milestones

Gross Motor Skills —> throws & catches ball, plays on slide independently

Fine Motor Skills —> holds pencil appropriately, begins to write name

Language —> explains events

Cognitive —> Pretend play

Vaccinations at Birth

Hep B (first dose)

*** Vitamin K (for clotting)

**** Erythromycin (prophylactic to avoid blindness linked to Gonorrhea & Chlamydia)

*** Not vaccines but given at birth

Vaccinations at 2 Months

Inactivated poliovirus (IPV) dose #1

Pneumococcal dose #1

Rotavirus (RV) dose #1

DTaP dose #1

Hib dose #1

Vaccinations at 4 Months

Inactivated poliovirus (IPV) dose #2

Pneumococcal dose #2

Rotavirus (RV) dose #2

DTaP dose #2

Hib dose #2 

Vaccinations at 6 Months

*** Inactivated poliovirus (IPV) dose #3

Pneumococcal dose #3 

Rotavirus (RV) dose #3 (depending on brand)

DTaP dose #3

*** Hib dose #3 (depending on brand)

influenza (every year after 6 months) 

*** Can be given anytime between 6-18 Months

12-15 Month Vaccines

MMR dose #1

Varicella (chickenpox) dose #1

Pneumococccal dose #4

Hep A dose #1

Hep A dose #2 (must be 6 months apart from first dose)

Hib Dose #3 or #4 (depending on brand)

DTaP dose #4 (15 months)

influenza (every year after 6 months) 

4-6 year vaccines

MMR dose #2 

Varicella (chickenpox) dose #2

DTap dose #5

Inactivated poliovirus (IPV) dose #4

influenza (every year after 6 months) 

11-12 year vaccines

Tdap dose #1

Meningococcal dose #1

HPV dose #1

influenza (every year after 6 months) 

16 year vaccines

Meningococcal dose #2

influenza (every year after 6 months) 

Newborn Vital Signs (first 4 weeks of life)

Heart Rate —> 110 - 160 * up to 180 if crying

Respiratory Rate —> 30 - 60 breaths/min

Systolic Blood Pressure —> 67 - 84 mmHg

Diastolic Blood Pressure —> 35 - 53 mmHg

Mean Arterial Pressure —> 45 - 60 mmHg

Infant Vital Signs (1 month - 1 year)

Heart Rate —> 100 - 180 bpm

Respiratory Rate —> 30 - 53 breaths/min

Systolic Blood Pressure —> 72 - 104 mmHg

Diastolic Blood Pressure —> 37 - 56 mmHg

Mean Arterial Pressure —> 50 - 62 mmHg

Toddler Vital Signs (1-2 years)

Heart Rate —> 98 - 140 bpm

Respiratory Rate —> 22 - 37 breaths/min

Systolic Blood Pressure —> 86 - 106 mmHg

Diastolic Blood Pressure —> 42 - 63 mmHg

Mean Arterial Pressure —> 49 - 62 mmHg

Preschooler Vital Signs (3-5 years)

Heart Rate —> 80 - 120 bpm

Respiratory Rate —> 20 - 28 breaths/min

Systolic Blood Pressure —> 89 - 112 mmHg

Diastolic Blood Pressure —> 46 - 72 mmHg

Mean Arterial Pressure —> 58 - 69 mmHg

School-Aged Child Vital signs (6-12 years)

Heart Rate —> 75 - 118 bpm

Respiratory Rate —> 18 - 25 breaths/min

Systolic Blood Pressure —> 97 - 115 mmHg

Diastolic Blood Pressure —> 57 - 76 mmHg

Mean Arterial Pressure —> 66 - 72 mmHg

Adolescent Vital Signs (13-17 years)

Heart Rate —> 60 - 100 bpm

Respiratory Rate —> 12 - 20 breaths/min

Systolic Blood Pressure —> 110 - 131 mmHg

Diastolic Blood Pressure —> 64 - 93 mmHg

Mean Arterial Pressure —> 73 - 84 mmHg

Kohlberg’s Theory of Moral Development

Preconventional:

• Punishing V. Obeying —> child believes that obeying rules will avoid punishment

• Focus on Self- Interest —> bad behavior may lead to punishment but it may be worth it

Convetntional:

• Social Acceptance & People Pleasing —> peers and social status become more important that right and wrong

• Rules are Flexible —> Rules/ Law exist to promote order BUT they can change or bend

Postconventional:

• Conscience & inner decisions —> makes decisions based on rules, past experience, and belief of good v bad.

• Ethics & Universal Principles —> behavior is based on person’s own moral principles

Piaget’s Stages of Cognitive Development

Sensorimotor Stage (0-2 yrs):

• development through the 5 senses

• development through motor response & reflexes

• Object Permanence is developed

Pre operational Stage (2-7 yrs):

• symbolic thinking

• imagination

• asks a lot of questions

• can only see the world from their point of view

• abstract thinking is still difficult

Concrete Operational Stage (7-11 yrs):

• Develops concrete cognitive operations

• conservation is developed (volume stays the same despite container shape & size)

• conductive reasoning (mathematical advancements)

Formal Operational Stage (11+ years):

• More rational, logical, organized, moral, & consistent thinking

• hypothetical thinking

• abstract concepts (love, hate, failures, successes)

• deductive reasoning